HB 20-1349: Colorado Affordable Health Care Option

• Beginning January 1, 2022, health insurance carriers offering individual plans in Colorado must offer a standardized "Colorado option plan" in all counties where they currently operate.

• The Colorado option plan must include essential health benefits, provide first-dollar coverage for primary and behavioral health care, maintain an 85% medical loss ratio, and require carriers to pass 100% of prescription drug rebates to consumers as premium reductions.

• Hospital reimbursement rates for Colorado option plan services are set at 155% of Medicare rates for 2022-2023, with adjustments for critical access hospitals, independent hospitals, and those serving high percentages of Medicare/Medicaid patients.

• A 9-member Colorado Option Advisory Board is created to advise the Commissioner of Insurance on plan development and implementation, with authority to override commissioner decisions by affirmative vote of at least 7 members.

• Hospitals that refuse to participate face escalating daily fines of up to $10,000 for the first 30 days and $40,000 per day thereafter, and may have their license suspended, revoked, or subject to conditions.